/m/otp

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This is why I’ve always been skeptical of self-described “political junkies.” Those most immersed in the daily thrust and parry of the game don’t always have the distance to understand why we engage in it.

Some people follow politics for the "horse race" aspect of it. They want to see who wins and who loses. Like a baseball fan, but seen as more "erudite". It's to the point that I was in a meeting years ago in which someone blamed the 2008 presidential contest for declining sports TV ratings.

Indeed, it is just like dissatisfied leftists to preemptively give up and try to attack their own.

For better or for worse, single payer is not what people are going to implement when looking at national health care. Not just here, but around the world in places like Singapore, Switzerland and beyond. Carping about how things could have been better or different ignores both political realities, and the fact that what we got was pretty damn good.

What's more, for all the cavailing about the website, Jeffrey Zients says today that things are working. Two months late, but not too late to get things going.

Average response time has dropped from more than 8 seconds to under a second.
System stability has improved from 45% to 95%
Error rates have dropped from 6% to below 1%.
System capacity has been upgraded to accept more than 800K users per day.

It is weird how the priorities go in the US. Heath care being single payer is dangerous but guns for all is good. Extremely weird to the rest of the world, seeing how the US pays far more for health care than any other country. I thought the US was the worst for gun deaths but actually is 12th according to Wikipedia (ahead of the US is third world countries, with biggest ones ahead being Mexico, South Africa and Brazil).

I get the idea of letting the market decide, heck I have an economics degree so I fully understand why that should be the default position. But external costs overrule market forces (ie: stuff the market won't consider that changes things from optimal to sub-optimal) and when it comes to health care the market will never be able to fully (or even get 1/2 way towards) factor in the value of a healthy work force.

The great being the enemy of the good is basically the story of the left. But there are many different healthcare models, and all are good/better than what America's throwing out at the moment.

Single payer gets mentioned a lot because that's what Canada has, and I suspect if Canada had something like Britain's National Health Service people would mention that. I love the NHS, although I've got a better chance of throwing a no-hitter in MLB than the NHS being instituted in America.

It's worth reading what healthcare models are out there - the UK and Ireland's version is different than France's version, which is different than Germany's, which is different to Italy's.

More insured people trying to see doctors, but many doctors are leaving the system, an inability to appeal a government IPAB decision (unless you make contributions to a politically connected PAC)....what could go wrong?

We are promising patients insurance, but that doesn't guarantee access to care - and cutting the quality of the care at the same time.

We are promising patients insurance, but that doesn't guarantee access to care - and cutting the quality of the care at the same time.

I will always remember the moment when Dems switched their banners from health care reform, to health insurance reform - without comment or explanation, in the middle of the public push for a new law - as one of the great Orwellian political moments of my lifetime.

More insured people trying to see doctors, but many doctors are leaving the system, an inability to appeal a government IPAB decision (unless you make contributions to a politically connected PAC)....what could go wrong?

The crucial shift there is going to be an opening up of more med school slots. The government essentially subsidizes both med school and residencies and allows the AMA to run an abnormally limited cartel. That's sustainable at the present time, but if doctors leave common insurance, they will gain short-term but lose long term, as it will make obvious the need to have more doctors, especially GPs. There should be far more GPs. The other possibility is the continuing expansion of the authority of Nurse Practitioners until they are essentially GPs.

In terms of cutting the quality of care, it's very complicated to figure out. There are some doctors who took very narrow insurances who now are leaving insurance altogether. That's a loss for people who got that kind of insurance but a net zero for most people. There are and have been for a long time doctors who took no insurance and who presumably still won't. To make sense of where we are going, you have to have a clear eye on where we are, and that means already that most people don't have access to most doctors, even people with quite good insurance.

When you cut doctor's medicare/Medicaid reimbursements, they will have to see more of these patients/hour to break even. Seeing more patients means less time/patient and perhaps an incomplete diagnosis - which can lead to worsening of missed conditions - lowered quality care.

My friends that have been doctors for a long time were looking forward to selling their practice to their younger doctors at some point. Under the current plans, the value of these practices will drop by 50% or more.

Additionally, one of my specialist friends has been told by their hospital that part of any savings incurred by their unit will be returned to them in bonuses. So, if you go for surgery and have to revisit the same doctor and need additional care, your chance of survival/recovery is lower and you may not be treated under the Hippocratic Oath's tenets.

In my case, if I lived outside the US (especially in the UK), revlimid (the drug that took me from high risk to the ability to deal with an autologous stem cell transplant) was not covered under NICE for over three months after I was diagnosed. Could velcade have worked? Maybe, but if it didn't I was going to be dead.

Now I get monthly white blood transfusions and have met many Canadians who travel to NYC because there are only 3 such centers for cancer patients in the entire Great White North.

In the long run, bending the cost curve of health care is going to mean that many doctors' salaries are going to move toward the norms of other industrialized countries' standards. That will be disruptive for the people involved--I have doctors in my family--and could mean some sorting in the people who go to med school, though presumably less than people imagine since doctors are being outearned wildly by financiers and by legal partners already and still have a wild excess of overqualified apps to grad programs. That shifting will be painful (and can be mitigated in the short term) but obviously we can't run our entire health care system in perpetuity to cause pain for everyone else in order to defer that inevitable shifting for a relatively small number of people.

If expectations of salaries change, then GPs would be able to see the same or fewer patients. That'll be shocking for some, especially well established people, but it will also open up opportunities to have more GPs which is something we hugely need. Who knows? It may even open up the possibility for doctors to have happier lifestyles. Many older physicians report earning more now but having a much worse quality of life given their scheduling.

If expectations of salaries change, then GPs would be able to see the same or fewer patients

How? There is still a limited amount of time in the day for any medical professional. They cannot magically see more patients, which means patients will now wait hours in line for routine or preventative care and weeks or months in advance for procedures to be scheduled.

Salary scales for high-end specialists will function differently.

So doctors will become government employees in a GS range? Sweet! They'll be as responsive as your average federal worker - and unable to pay off their ten years of students loans.

My solution - hospitals and the government should give scholarships and tax benefits for those that agree to become GP's.

You have to understand at the start that nothing about doctor'a current compensation for most specialisties is set by the market. There is cartel pricing formed by licensing boards lobbied by the most important lobbying group over us history with a primary goal of constant supply shortages. That has some good effects and it is also true that a society should be thoughtful with older workers as it moves to eliminate their publicly funded subsidies. But it is also true that almost nothing could make the doctor supply less market driven than it currently is. Opening up more gps and using Medicare reimbursements to slowly lower salaries is not the government intruding on the market; it is the government slowing moving the market in to a cartel.

The market solution would be true libertarian market of let people train as they want, have moderate review, and let consumers select. That actually would be better than the current system and places with historic openness to osteopaths don't show any lower health care outcomes than places resistant to them.

My moderate solution would be doubling the number of med school slots over a decade or two while also slowly pushing down reimbursements. I suspect the difference in care would be impossible to find. Certainly friends who teach in med schools have told me the admissions procedures now are irrelevant for training good gps. Which isn't the goal of most med schools anyway

It's worth reading what healthcare models are out there - the UK and Ireland's version is different than France's version, which is different than Germany's, which is different to Italy's.

T.R. Reid's The Healing of America is still the best survey of the health care systems in the rest of the developed world.

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In the long run, bending the cost curve of health care is going to mean that many doctors' salaries are going to move toward the norms of other industrialized countries' standards. That will be disruptive for the people involved--I have doctors in my family--and could mean some sorting in the people who go to med school, though presumably less than people imagine since doctors are being outearned wildly by financiers and by legal partners already and still have a wild excess of overqualified apps to grad programs. That shifting will be painful (and can be mitigated in the short term) but obviously we can't run our entire health care system in perpetuity to cause pain for everyone else in order to defer that inevitable shifting for a relatively small number of people.

Perhaps if medical school were tuition-free, and if only primary care interns were paid during their residencies, you'd see more medical students not having to go into the higher priced specialty practices as a way of getting out from under their six figure student debt. This and more good ideas addressing this subject are advanced by this op-ed article from 2011.

"First, Congress should return to a five-day workweek and commit to “regular order.” Leadership should schedule votes on Fridays and Mondays to accommodate a more ambitious legislative agenda....

Second, joint caucuses should be scheduled at least once a month...

Third, end the Senate practice of “holds.” Members of both parties have abused this practice, which is now tantamount to a veto.....

Fourth, initiate weekly meetings at the White House and quarterly weekend meetings at Camp David. Regular engagement between the president and leaders of Congress is necessary..."

First point requires campaign finance reform. McConnell is a strong opponent and it would not pass the house.

Second point would do nothing but whatever.

Third point: doubt either party really wants this as it would amount to a significant erosion of an individual senator's authority. Both sides have abused this practice, but more on the side of Republicans. Leahy has committed to respecting all blue slips, which is a principled, but stupid position.

Fourth: This would do nothing but whatever.

So of the four solution points, you have two that are meaningless, one that would never pass due to R position on campaign finance and one that both parties would probably oppose.

My solution - hospitals and the government should give scholarships and tax benefits for those that agree to become GP's.

Only works if there are string attached. Otherwise the colleges will say thank you to the money, then their prices will magically go up to the point where they are getting the same amount from the students as they were before. It will be just free money to them. If you say to the colleges, "here's a basket of money, you can have your share but here's how much you can charge in tuition, find a way to make it work", then you have some control.

Our family has our insurance through an HMO. Not an ideal setup, but I'm sure limiting choices does limit costs. We just had our choices limited, since the doctor's group our pediatrician is in broke with the HMO. So we had to get a new one. Nice children's hospital in town. Not part of the HMO, we can't use it. Though we got to use it when our son had a fever spike and the ER doc insisted we go there instead of our HMO hospital a mile away. Son was fine afterward, but it was still overnight and a 4K bill. HMO was fine with paying because of the ER doc. Though every dealing with the HMO is usually multiple calls to get the billing straight.

The actual children's hospital we are supposed to use is about 200 miles away, in another state.

So the system is kludgy and not perfect. But some sort of care management is the way of the future. You can try to influence who has the power in that management, but the Wild West system we currently have has got to go.

Half the doctors of the future wouldn't be good enough to get into medical school today? And doing this while pushing down doctors' compensation? Might not work that well.

The idea advanced by that second link in #16 wasn't to push down specialists' compensation, at least not once they emerged from their internship. It was to provide up-front financial incentives for pre-meds to choose a primary practice instead.

I will always remember the moment when Dems switched their banners from health care reform, to health insurance reform - without comment or explanation, in the middle of the public push for a new law - as one of the great Orwellian political moments of my lifetime.

When was that? How do you do with reforming the medical industrial complex without addressing the insurance issue in this country? I mean, since single payer or any government dominated system is off the table.

An underdiscussed problem is that there are too few doctors. And there are too few because that's the way the guild wants it. Right now, doctors depend more and more every day on para medical assistants to do what use to be their duties. Of course they charge as if they are doing the ministering themselves, at a higher rate, but it's the lower cost personnel who do a lot of it.

Half the doctors of the future wouldn't be good enough to get into medical school today? And doing this while pushing down doctors' compensation? Might not work that well.

I think the issue isn't so much that half the doctors of the future wouldn't be good enough to get into medical school, as it is that we lose a high percentage of people who want to be doctors due to the high residency/internship requirement.

I will always remember the moment when Dems switched their banners from health care reform, to health insurance reform - without comment or explanation, in the middle of the public push for a new law - as one of the great Orwellian political moments of my lifetime.

When was that? How do you do with reforming the medical industrial complex without addressing the insurance issue in this country? I mean, since single payer or any government dominated system is off the table.

I can't remember when the Democratic / liberal focus on health care reform wasn't centered on the issue of affordable insurance.

Someone on another board had the opinion that the tax reform changes in 1986-87 had a far greater change on the insurance marketplace than what's going on today will. The changes to tax-exempt status encouraged many non-profit insurers to switch to for-profit. Now apparently this was encouraged by the companies themselves so the CEOs could make more money, so it may have been unpreventable given the climate of the time. Does anyone have more information on this? I just know what little I've read, and don't have an article at hand that discusses the topic.

Half the doctors of the future wouldn't be good enough to get into medical school today?

Currently med school has roughly a 50% acceptance rate, while the graduation rate after 4/5/7/10 years is 81%/91%/94%/96%*. Almost all of the non-graduation rate are people choosing to drop out of med school, as opposed to be failed out. Those numbers strongly imply that we could add increase the med school acceptance rate by 20% and get 15% more new doctors per year.

And yes, those doctors would be slightly worse than the current average, but the type of doctor we need are general practitioners, not high end specialists.

*I pulled med school graduation rates from the AAMC's paper on med school graduations rates. From what I can tell, 4 years is normal, 5 years is vaguely slow, and the longer term graduation rates come from either dual MD/Ph.D programs or really slow graduates. It's worth noting that the initial line of the paper suggests increasing current acceptance rates by 30%.

Edit: This is also ignoring the fact that applying to med school is fairly brutal, and any attempt to make it easier to get into med school will increase the number of applicants, since they will be less scared off by the fact that applying to med school is brutal.

I have a good friend who completely rational in every way -- except when it comes to Mr. Obama. She insists that there's nothing wrong with the healthcare.gov website, that unemployment isn't really as high as the numbers indicate, and if there's anything wrong in DC at all, it's because of Republican "obstructionists". All of it. And she says all this with a straight face, with the fervor of a true believer.

I have a good friend who completely rational in every way -- except when it comes to Mr. Obama. She insists that there's nothing wrong with the healthcare.gov website, that unemployment isn't really as high as the numbers indicate, and if there's anything wrong in DC at all, it's because of Republican "obstructionists". All of it. And she says all this with a straight face, with the fervor of a true believer.

It's not politics. It's religion.

She does have the last one at least partially right. Take away the Republican obstructionism and we'd have a far better functioning ACA, immigration reform, appointments that got filled without gratuitous delay, and an end to the obsession with eviscerating the budget. But most of the ACA website problems would exist on their own, and the official unemployment figures if anything don't reflect the degree to which unemployment is a persistent cancer in today's economy.

This is also ignoring the fact that applying to med school is fairly brutal, and any attempt to make it easier to get into med school will increase the number of applicants, since they will be less scared off by the fact that applying to med school is brutal.

It also doesn't account for the number of students who don't even consider a medical career because of the high cost of tuition and the prospect of overwhelming student debt. Eliminating med school tuition would surely result in many of these prospective doctors seeing a medical career as a lot less daunting.

Take away the Republican obstructionism and we'd have a far better functioning ACA, immigration reform, appointments that got filled without gratuitous delay, and an end to the obsession with eviscerating the budget. But most of the ACA website problems would exist on their own, and the official unemployment figures if anything don't reflect the degree to which unemployment is a persistent cancer in today's economy.

Yes, the GOP/TP are intransigent radicals hell bent on taking down the government as a functional entity. But at some point the Democrats have to own being The Other Party Of Doctrinaire Wall Street Fundamentalism too.

Or maybe I shouldn't re-read painfully predictive Tom Frank texts from 2000 and admit that if the Dow is rising, "the economy" must be doing great.

She does have the last one at least partially right. Take away the Republican obstructionism and we'd have a far better functioning ACA, immigration reform, appointments that got filled without gratuitous delay, and an end to the obsession with eviscerating the budget. But most of the ACA website problems would exist on their own, and the official unemployment figures if anything don't reflect the degree to which unemployment is a persistent cancer in today's economy.

#14 Well you have the Canadian example. Canadian doctors are not civil servants, but in a very real way their salary is set by the system. Canadian doctors make a lot less than US doctors (and as a side bonus generally face higher tax rates), Bbut they still make very good money.

Canada loses a fair number of doctors to the US every year (some come back -- generally out of frustration with the US system -- but there's a net loss), in spite of which ... Well, Canadians are generally happier with the medical system than Americans are. I've had a fair amount of experience with both systems and in terms of quality of care I can't see that the extra costs to the US system is buying anything.

And yes, the Canadian system is not particularly good at elective surgery specifically. As I've said before, the Canadian system is not one I'd advocate. But the specific objection you raise is not a problem.

Canadian doctors are not civil servants, but in a very real way their salary is set by the system. Canadian doctors make a lot less than US doctors (and as a side bonus generally face higher tax rates), Bbut they still make very good money.

1. Canada is essentially Communist.

2. If "doctors" can't be assured of making a quarter mil or better per year, clearly no one would ever choose to enter the "caring for others" professions at all.

I have a good friend who completely rational in every way -- except when it comes to Mr. Obama. She insists that there's nothing wrong with the healthcare.gov website, that unemployment isn't really as high as the numbers indicate, and if there's anything wrong in DC at all, it's because of Republican "obstructionists". All of it. And she says all this with a straight face, with the fervor of a true believer.

It's not politics. It's religion.

Not to discount the kernel of truth here.... but let's be serious about the healtcare.gov issues for a moment.... The failure rate - i.e., crash rate - was what... 6-7%? Now, sure - that's terrible. No commercial website survives long if 6 or 7 out of 100 users see their session end with an error code of some sort. The average response time for most protocols was 8 seconds... Again - that's an unacceptable number.

But perhaps now we can at least offer up a little perspective?

I mean, to hear even the so-called liberal media tell it -- the website had gained sentience and was indiscriminately electrocuting an orphan every time someone tried to log onto it.

She insists that there's nothing wrong with the healthcare.gov website, that unemployment isn't really as high as the numbers indicate...

I admit curiosity over what she actually said vs. what you've reported. Has she said the website has always worked 100% perfectly, or has she said the problems are completely inconsequential? Those are not the same thing.

As far as unemployment numbers go, everyone always says they are fictional. So much crying wolf all over I see no reason to believe anyone about them. Congratulations, everybody.

When you cut doctor's medicare/Medicaid reimbursements, they will have to see more of these patients/hour to break even. Seeing more patients means less time/patient and perhaps an incomplete diagnosis - which can lead to worsening of missed conditions - lowered quality care.

Depends what the issue is. The NHS allows ten minutes per patient. In my experience this is perfectly adequate for almost every issue except more specialist care, in which case you'd be seeing a specialist and get a longer time, or the GP will just take longer than 10 minutes to let you go through your issue.

In my case, if I lived outside the US (especially in the UK), revlimid (the drug that took me from high risk to the ability to deal with an autologous stem cell transplant) was not covered under NICE for over three months after I was diagnosed. Could velcade have worked? Maybe, but if it didn't I was going to be dead.

Sure, OK. And when it entered NICE, the NHS probably negotiated a price that was significantly cheaper than what US healthcare providers negotiated for it, because when you negotiate for 60 million people, you hold quite a bit of leverage. And you could still get revlimid, you'd just have to pay for it. The NHS tends to be pretty flexible in getting you care when you absolutely need it or you'll die, it's the non-chronic stuff they tend to do slower. And most people are OK with that, because they do it to save the taxpayer money. The NHS is one of the cheapest national health care services going.

You know, mentioning Marx four times in the first three paragraphs, including the sub-headline, then at least twice more in the article including the conclusion, along with a picture flanking the pope in order to say "oh, not REALLY, but.." is enough passive-aggressiveness to make the article almost too irritating to read.

You know, mentioning Marx four times in the first three paragraphs, including the sub-headline, then at least twice more in the article including the conclusion, along with a picture flanking the pope in order to say "oh, not REALLY, but.." is enough passive-aggressiveness to make the article almost too irritating to read.

Yeah, I can see that. There is a real problem with the vast majority of Americans, especially the type of Americans who get gigs writing for what amounts to a DC consensus monthly like The Atlantic, is that they pretty much universally fall into the "if it's not Hayek flavored hyper-capitalism, it must be Marxism" trap way to easily.

I am at least happy to promote a little an article that acknowledges that there are other theories of social organization outside of Galt's Gulch vs the Gulag Archipelago.

I mean, to hear even the so-called liberal media tell it -- the website had gained sentience and was indiscriminately electrocuting an orphan every time someone tried to log onto it.

From a purely political perspective, I'd rather have the serious media continuing to point out the flaws in the execution of the ACA, because when it gets reported in the Times or the Post or on the News Hour, you can bet that the people in charge are paying attention, and won't ease up until it's set to run like it should. And that includes the so-called "back end".

And assuming that the people in charge aren't totally incompetent, and the system doesn't crash for whatever reason, then all those scare stories that the trash media are harping on to the exclusion of everything else are eventually going to run up against reality. If and when it gets to that point, I think that the saboteurs are going to look like nothing more than saboteurs, and not the prophets they're now claiming to be.

But in the meantime, I hope the serious media don't let up until every goddam thing about the ACA is running like it was supposed to, with or without any help from the Republican saboteurs. One thing we can all agree on is that Obamacare is owned by Obama, and if it works out well in the end, the Republicans are going to look like nothing but a bunch of gasbags.

Yes, it will be set up to run like it should. This happens with government any time a radical program is instituted. Hell, it happens all the time in the private sector. How many times have the automotive/computer/electronic industry come up with an Edsel? That should be expected. The government can't help but go by cluster ####. That's because we have no commitment to the concept of good government and we allow (unlike the private sector) the opposition to run interference contemporaneously with those in charge. It's wasteful and it's remarkable anything gets done at all. That it does has to do with our tremendous wealth--we can tolerate the waste. If there ever comes a time we can't, we'll be in deep ####. Because we have no Plan B.

this might be my favorite issue where the diehards in both camps don't even see the irony.

without fail, the party out of power constantly harps on the fact that the unemployment rate isn't the 'real' rate because it doesn't include those who have just given up on finding a job, period. so they mewl about how bad life is under the other guy's rule.

but the MINUTE their guy gets into the Oval Office, both sides do backflips - now those in power forget that "shadow unemployment rate" ever existed, while the other guys suddenly rediscover this issue they had forgotten for years.

Fox has been doing this forever, it seems, and MSNBC got into it during Bush II and forgot it once Obama took power.

It's a perfectly reasonable talking point for either side - the odd part is simply the unconscious shifting of the discussion from one side to the other based on who's in power.

I love how you just throw that "radical" in there without thinking, Morty.

It's not "radical" in the way that the mouthbreathers are claiming, but it's "radical" in the sense that nothing like the ACA has ever been attempted on a national level. Medicare is essentially single payer, and the many and varied health care systems around the developed world aren't anything quite like Obamacare, with governors and state legislatures and courts going out of their way to gum up the works. It's not radical/leftist, but it is radical/virtually unprecedented.

I have a good friend who completely rational in every way -- except when it comes to Mr. Obama. She insists that there's nothing wrong with the healthcare.gov website, that unemployment isn't really as high as the numbers indicate, and if there's anything wrong in DC at all, it's because of Republican "obstructionists". All of it. And she says all this with a straight face, with the fervor of a true believer.

It's not politics. It's religion.

I suppose such lefties exist, I've never met one personally, but I assume they exist, I have met their righty opposite number so I know they exist...

To be fair to the political nuts, I find the apolitical (non partisan is perhaps a better word) nuts to be far more common, you know the people convinced that vaccines cause autism, or that the moon landings were faked.

It's not "radical" in the way that the mouthbreathers are claiming, but it's "radical" in the sense that nothing like this has ever been attempted on a national level.

A fair position to take, and perhaps the intended meaning of Morty's use of the term. But IMHO the term "radical" has acquired far too much excess baggage to be used with nuance, unless you explicitly call out the nuance while using it so.

I love how you just throw that "radical" in there without thinking, Morty.

Perfectly willing to clarify (although I think it's obvious from the context of the discussion) that I was not using "radical" in a substantive political philosophical sense, but in a government/bureaucratic structural/institutional sense. And then of course what's radical here in the USA may not be radical elsewhere.

Perfectly willing to clarify (although I think it's obvious from the context of the discussion) that I was not using "radical" in a substantive political philosophical sense, but in a government/bureaucratic structural/institutional sense. And then of course what's radical here in the USA may not be radical elsewhere

I'm confused by this civil exchange of thoughts and clarification of points.

Well, essentially, everyone has everyone else on ignore. I refer you to John Lennon's "Strange Days". Or just notice people in public--all on their cellphones, everyone talking but not to each other, giving a surreal but erroneous impression that they are, though. Most peculiar, mama.

What would it take to make Americans take Francis' critique of capitalism seriously? Is it even possible?

The continued (and inevitable) erosion of the average standard of living effectively insures it, though I have little to no hope the frustration with the oligarchs gets expressed constructively via the ballot box.

The continued (and inevitable) erosion of the average standard of living effectively insures it, though I have little to no hope the frustration with the oligarchs gets expressed constructively via the ballot box.

The world moves fast at times; cf "gay marriage" for example. But I don't think we're close enough to even discuss "how would it be taken seriously enough to impact elections as currently funded in the United States." I'm interested in how this critique, this *radical* evisceration of the alter of deified capital, could possibly percolate within the US and become something more powerful than "something the Pope said that made Business Insider gasp." We've seen this type of critique from the left - the actual left, not the DLC or Barack Obama - for years now. My go-to example is Thomas Frank (whom I've had a man crush on for more than a decade) but there are plenty of others. But those have been written off near universally as "radical leftist" and "socialists" and "Marxists," etc, et al. Enter the parade of convenient bucket labels to avoid having to constructively engage the meat of a critique from right-thinking "centrists" much less "conservatives."

I guess what I want to know is if this same rhetoric of left-leaning critique of capitalism will gain more traction with the "alternative right" we've heard so much about, or if this too will be buried under the heading "class warfare by the takers against the Masters of the Universe."

I'm interested in how this critique, this *radical* evisceration of the alter of deified capital, could possibly percolate within the US and become something more powerful than "something the Pope said that made Business Insider gasp."

Short of some kind of huge, dislocating war or natural disaster, I don't think it's possible.

I guess what I want to know is if this same rhetoric of left-leaning critique of capitalism will gain more traction with the "alternative right" we've heard so much about, or if this too will be buried under the heading "class warfare by the takers against the Masters of the Universe."

It's a great question. I don't know the answer, but I will say that if ever such a critique would be able to gain some actual real-world impact instead of being swept away as so much whining lefty BS, it would have to be when it's coming from the flipping Pope.

The people who sincerely listen to -- no, heed -- what the Pope says are serious and devout Catholics, and they tend to be quite conservative people. If conservative people in the US and worldwide were to take what the Pope has said (and, let's fervently hope, will continue to say) seriously, then that could have real and important political effect.

Again, I don't know that it will, but I'm about a thousand per cent more optimistic that it will since the Pope has said this than if one of the usual suspects had said it.

Short of some kind of huge, dislocating war or natural disaster, I don't think it's possible.

As a born cynic and pessimist, that's my assumption as well. I suspect the American masses are too far away from actual poverty and suffering, buffered by rank consumerism enough to mollify the rank failure of their democracy, and too in thrall of "the prosperity gospel" and the self-righteous satisfaction of "deserving to be well off" to listen to a silly old pontiff. And I suspect the Catholic right in America will just sit patiently at the foot of the calf and wait for a reactionary Pope to come along and replace Francis. I can't imagine Sam Alito or Antonin Scalia will be taking their pontiff's words to heart any time soon. And of course, a large section of protestant America will just throw the Catholics back into the "Satanists and other evil types" grab bag.

without fail, the party out of power constantly harps on the fact that the unemployment rate isn't the 'real' rate because it doesn't include those who have just given up on finding a job, period. so they mewl about how bad life is under the other guy's rule.

but the MINUTE their guy gets into the Oval Office, both sides do backflips - now those in power forget that "shadow unemployment rate" ever existed, while the other guys suddenly rediscover this issue they had forgotten for years.

Or do like Kehoskie was fond of doing a while back: take one from column A and one from Column B. He would cite the official reported unemployment numbers when Obama first took office, and then claim he was doing so much worse by citing the "real" rate now (or then, when the argument was going on). And, as a bonus, he would throw in the underemployment numbers, and passively-aggressively proclaim: "Hey, I'm not saying Obama went from 9% to 23%, but you can't argue with the numbers."

The people who sincerely listen to -- no, heed -- what the Pope says are serious and devout Catholics, and they tend to be quite conservative people. If conservative people in the US and worldwide were to take what the Pope has said (and, let's fervently hope, will continue to say) seriously, then that could have real and important political effect.

I ask the question specifically because of this. There is a window here, I think, where something truly different might happen. I doubt it *will*, but there's a window of opportunity where it *could.* Where the "alternative right" who proclaim loudly that they are interested deeply in exiting "the Cathedral" might come to terms with their basic, social alignment with those nefarious dirty "socialists" and "Marxists" they so viciously condemn. That, if nothing else, makes Francis an obscenely interesting actor on the world stage right now.

That, if nothing else, makes Francis an obscenely interesting actor on the world stage right now.

Entirely agreed. He's stepped up and provocatively spoken truth to power in a way no Pope has done in I don't know how long, but a very, very long time. He's suddenly made relevant to those outside of its parishioners an institution that had earned a brand name associated with little more than a disgusting haven for sexual predators alongside futile pissing into the wind of evolving social morality.

The problem here is that all of the voices agreeing with me are generally "liberals." I don't see Good Face popping up here. I don't expect, say, Ray to agree. But it would be interesting to get the read of avowed right wingers other than doctrinaire Libertarians.

That, if nothing else, makes Francis an obscenely interesting actor on the world stage right now

Eh, I don't think so. Speaking again of cynicism, I think it's going to be very - almost shockingly - easy for a majority of human beings, Christian or not, to ignore the Pope's pleas for sanity in this particular arena. Eastern religion has been consistently phasing out of importance as the years pass; the lack of ears given to this bit from the Pope will probably assist in continuing that trend, only now among a whole new wedge of population.

I guess what I want to know is if this same rhetoric of left-leaning critique of capitalism will gain more traction with the "alternative right" we've heard so much about, or if this too will be buried under the heading "class warfare by the takers against the Masters of the Universe."

Many of the folks on the alt right are critics of "Free Market" capitalism. But they hold no more sway with the GOP than actual Marxists hold with the Dems.

As a born cynic and pessimist, that's my assumption as well. I suspect the American masses are too far away from actual poverty and suffering, buffered by rank consumerism enough to mollify the rank failure of their democracy, and too in thrall of "the prosperity gospel" and the self-righteous satisfaction of "deserving to be well off" to listen to a silly old pontiff.

As I've said before, fat people make lousy revolutionaries. As long as our elites can keep the poor masses well-fed and reasonably entertained, they have nothing to worry about. The only question is whether they can effectively complete their elimination of the middle classes, or people who think they ought to be middle class, in time. Those are the folks who have wants and expectations that aren't being met.

I'm hopeful that, if only 20% of the "Reagan Democrat" crowd, meaning working class Catholics, come back to Team Blue, it will make it virtually impossible for a Republican to be elected president. Given enough time, the Supreme Court and many of the federal appeals courts will be led by more moderate judges, and the country will be back to a more normal progressive footing. What I also like is the decoupling of the Catholic church with the Protestant Evangelicals, an alliance which has proved itself so politically disastrous.

I was initially sceptical of Pope Francis but he's setting himself up to be a figure of genuine historical figure, and in a good way.

Speaking again of cynicism, I think it's going to be very - almost shockingly - easy for a majority of human beings, Christian or not, to ignore the Pope's pleas for sanity in this particular arena.

Agreed (not surprisingly). Hasn't the Bible, particularly the New Testament, been saying pretty much all of this for quite a few centuries now? Any number of "Christians" have had no problem completely ignoring, or at least completely (ir)rationalizing away, those tenents, or so it seems to me.

What the Pope said is basically century old Catholic social thought. Rerum Novarum dealt with this over 100 years ago. In a way, it's kind of why right-wing parties in Europe don't worship the sacred cow of the free market to the same extent the Republicans or the British Conservative Party does.

To be fair to the jerk, Benedict said some of the same things from time to time, but he was clearly not interested in it as much as he was interested in turning the vice grip on the more liberal elements of the Church.

Hasn't the Bible, particularly the New Testament, been saying pretty much all of this for quite a few centuries now?

Yes. But it's amazing how easy it is to ignore your proclaimed fundamental beliefs when the rubber meets the road.

What the Pope said is basically century old Catholic social thought. Rerum Novarum dealt with this over 100 years ago.

See above.

I'm hopeful that, if only 20% of the "Reagan Democrat" crowd, meaning working class Catholics, come back to Team Blue, it will make it virtually impossible for a Republican to be elected president

That only benefits the world if "Team Blue" actually moves to some sort of economic policy that takes the concerns of working class human beings seriously. As it currently stands, "Team Blue" is only the lesser of two evils because rather than attempting to advance the causes of Mammon in the world vigorously it preaches a "Mammon is too powerful to be countered, even if we were interested in doing that rather than taking their campaign donations in droves."

My hope as a cynical Jesuit-taught leftie: the Pope's words will be heard for once by the 'younger generation' and maybe in 15-20 years when the boomers have gone, there are adjustments. After Benedict, Francis seems to be hitting home with more and more people.

But, it's not new - JP II said it, and it's been doctrine. It's been drowned out by abortion and homosexual-demonization in a wonderful display of tone-deafness by Catholics. Francis, if he is around long enough, may begin to refocus what the Catholic Church should be doing primarily. Feeding the hungry, caring for the poor... you know - Jesus-stuff.

That only benefits the world if "Team Blue" actually moves to some sort of economic policy that takes the concerns of working class human beings seriously.

It does. It wants to put them on the dole. That's not really a great policy, but it's the best they can come up with since...

As it currently stands, "Team Blue" is only the lesser of two evils because rather than attempting to advance the causes of Mammon in the world vigorously it preaches a "Mammon is too powerful to be countered, even if we were interested in doing that rather than taking their campaign donations in droves."

They're actively working to further the causes of Mammon. They take Mammon's money and they work its will; since the current arrangement works so well for Team Blue, it's foolish to expect anything better from them.

It does. It wants to put them on the dole. That's not really a great policy, but it's the best they can come up with since. They're actively working to further the causes of Mammon. They take Mammon's money and they work its will; since the current arrangement works so well for Team Blue, it's foolish to expect anything better from them.

Haven't you said repeatedly you're in favor of the dole? Are you slagging the Dems for keeping your own favored policy?

I can't see the Catholic Church as revitalizing itself so easily. As part of religion, it is but an undeniably moribund institution. It's been seen through. That vector is not deflected by any wishy-washyness here and there. The Pope in a way is a refreshing figure, because he shows a hint of being one we haven't seen in a while, but it's too little too late. His worn-out dogmatism will show itself. To change comparisons, he's like a dog walking on its hind legs. We laugh and applaud, but it means nothing--because no matter how you cut it, it's just a dog walking on its hind legs. The Wizard of Oz is just that old fool behind the curtain.

My conservative take is that Francis is to the Vatican as Barack Obama was to DC in January, 2009. Except he's keeping up the hopey-changey talk *after* taking office where Obama was hopey-changey before taking office. Which may be a function of how the office is awarded in each case, really.

I don't think oligarchs -- and let's face it, we live in an oligarchy today -- make compromises because polite discussion causes people generally to believe in common fairness and justice. I think oligarchs make compromises because they're afraid. It doesn't have to be fear of physical violence, it might be because politicians fear the loss of office and perks. I'm hardly the first to say it, but Republican officeholders fear their base. Until that becomes true for Dems and the liberal base, improvements will be agonizingly slow.

I don't think oligarchs -- and let's face it, we live in an oligarchy today -- make compromises because polite discussion causes people generally to believe in common fairness and justice. I think oligarchs make compromises because they're afraid. It doesn't have to be fear of physical violence, it might be because politicians fear the loss of office and perks. I'm hardly the first to say it, but Republican officeholders fear their base. Until that becomes true for Dems and the liberal base, improvements will be agonizingly slow.

I don't think oligarchs -- and let's face it, we live in an oligarchy today -- make compromises because polite discussion causes people generally to believe in common fairness and justice. I think oligarchs make compromises because they're afraid. It doesn't have to be fear of physical violence, it might be because politicians fear the loss of office and perks. I'm hardly the first to say it, but Republican officeholders fear their base. Until that becomes true for Dems and the liberal base, improvements will be agonizingly slow.

I agree wholeheartedly with this.

I think it was Joe Kennedy who said of FDR that plenty of people like him went along with the New Deal and were perfectly fine with redistributing half their wealth so long as it meant they could get guarantees on being allowed to keep the other half.

I think of the dole as a necessary evil. That doesn't mean I love it or believe it's something more than it is though.

Is there a single person here who doesn't view "the dole" as anything more than a necessary evil? If anything, it's been conservatives who oppose measurements to combat unemployment via public works programs, and it's conservatives who've kept minimum wages down to the point where supplemental income policies, AKA "the dole", are a requirement for survival.

Is there a single person here who doesn't view "the dole" as anything more than a necessary evil?

Well, yeah. Capitalists. "The dole" provides a floor for wages. A labor force with access to "the dole" will not work for pennies on the dollar. This means the cost center of labor can't be reduced to a pittance, and thus share prices aren't even more inflated. This is the basic problem capital has with minimum wage laws and the welfare state in general. It sets a lower boundary on how low "wage slavery" can be driven, which cuts into the profit margins at the top. All of the harping and whinnying about "people would rather be on welfare than work" as a pseudo-moral problem is, in fact, a simple economic calculus of wealth transfer from the bottom to the top.

In July, the U.S. 4th Circuit Court of Appeals rejected the claim and said the federal government could regulate employers under its constitutional power to regulate interstate commerce.

“We find that the employer mandate is no monster; rather it is simply another example of Congress’s longstanding authority to regulate employee compensation offered and paid by employers in interstate commerce,” said the appeals court based in Richmond, Va.

Liberty University appealed again to the Supreme Court, arguing that the justices should rule directly on the constitutionality of the employer mandate. On Monday, the court turned down the appeal without comment.

Limbaugh vs Pope Francis... talk about the mismatch of the century. Though Rush does have a sizable weight advantage.

RUSH: I was doing show prep last night, usual routine, and I ran across this -- I don't even know what it's called, the latest papal offering, statement from Pope Francis. Now, I'm not Catholic. Up until this, I have to tell you, I was admiring the man. I thought he was going a little overboard on the common-man touch, and I thought there might have been a little bit of PR involved there. But nevertheless I was willing to cut him some slack. I mean, if he wants to portray himself as still from the streets where he came from and is not anything special, not aristocratic. If he wants to eschew the physical trappings of the Vatican, okay, cool, fine. But this that I came across last night totally befuddled me. If it weren't for capitalism, I don't know where the Catholic Church would be.

Pshaw. Everyone knows it's the other way around -- vaccines are faked, & the moon landings caused autism.

Please, y'all aren't even in the running!

Rev. James David Manning, pastor of Atlah World Missionary Church who believes the president was born in Kenya, claims that Carey’s family has called for a paternity test to determine whether the woman’s 15-month-old daughter was fathered by the president.

While Carey’s family has indeed asked U.S. Attorney General Eric Holder to look into the fatal shooting, the only source for the claim about the family’s request for a paternity test seems to be additional videos posted online by Manning.

He also links to a Change.org petition purportedly set up by Carey’s sister asking for more investigation, but that too fails to mention a paternity test.

Eric Sanders, an attorney for the Carey family, has said police violated their own policies by firing at a moving car after they said the woman refused to stop at a security checkpoint, turned around and tried to flee, knocking down a Secret Service agent and a bicycle rack.

But he stopped short of suggesting that authorities had deliberately targeted Carey or that she might have had a connection to Obama.

That only serves as proof of a conspiracy and cover-up, according to Manning.

“No one has come to the aid of this slaughtered woman, which means they are protecting something that they feel is far more important, and that’s the hardcore, incontrovertible evidence and that which is being protected is Barack Hussein Obama,” Manning said, adding: “Case closed.”

Manning, who has previously hosted a woman on his program who claimed that Obama had traded gay sex for cocaine as a teenager and bummed cigarettes without offering thanks, isn’t the only source for the “love child” theory.

A website called What Does It Mean? claims that Russian authorities have developed intelligence showing that Obama fathered Carey’s child during an emergency dentist visit May 18, 2011.

According to the theory, Obama had gone to New London, Connecticut, to address the graduating class at the U.S. Coast Guard Academy but needed dental work after a portion of a pistachio nut shell became lodged in one of his molars.

The president met Carey, who worked as a dental assistant for the local dentist he saw, and struck up “an almost immediate friendship” with her.

She became pregnant following the affair, the website claims, but refused the president’s instructions to have an abortion due to her Christian beliefs.

The site claims that encrypted electronic communications intercepted by the National Security Administration show that an elite hit squad was dispatched to kill Carey.

This same squad also attacked the U.S. Navy Yard in September and in June killed American journalist Michael Hastings and detectives investigating his death, according to the conspiracy theory.

Just in case the theory wasn’t convoluted enough, the site also claims that Obama engaged in the extramarital affair because his wife, Michelle Obama, was in fact born a man.

A website called What Does It Mean? claims that Russian authorities have developed intelligence showing that Obama fathered Carey’s child during an emergency dentist visit May 18, 2011.

This may possibly be the greatest sentence I have ever read.

That's something right out of Monty Python. Like one of John Cleese's fake news reports"

" And while that's going on, here from Westminster is a parliamentary report for Humans.

In the debate, a spokesman accused the goverment of being silly and doing not at all good things. The member accepted this in the spirit of healthy criticism, but denied that he had ever been naughty with a choir boy. Angry shouts of 'What about the Watermelon then?' were ordered then by the speaker to be stricken from the record and put into a brown paper bag in the lavvy. Any further interruptions would be cut up and distributed amongst the poor. For the Government, a front-bench spokesman said the Agricultural Tariff would have to be raised, and he fancied a bit. Futhermore, he argued, this would give a large boost to farmers, him, his friends, and Miss Moist of Knightsbridge. From the back benches there were opposition shouts of 'Postcards for sale' and a healthy cry of 'Who likes a sailor then?' from the minister without portfolio. Replying, the Shadow Minister said he could no longer deny the rumors, but he and the Dachshund were very happy. And in any case he argued Rhubarb was cheap, and what was the harm in a sauna bath?"

Winds were calm in the capital on Monday, except in the immediate vicinity of the White House, where gale-force exhalations were blowing out of the West Wing.

After the administration’s claim Sunday that star-crossed HealthCare.gov had been repaired with “private sector velocity,” and the site’s relatively smooth functioning on Monday, Obama administration officials moved with aerospace-sector velocity to celebrate meeting their self-imposed deadline.

“We feel confident about the site working now as it was intended,” Jennifer Palmieri, the White House communications director, told MSNBC’s Chuck Todd on Monday morning, following the claim by Jeffrey Zients, who led the Web site turnaround, that “night and day” improvements had been made.

Press secretary Jay Carney announced that the site had weathered 375,000 visitors in the first 12 hours of Monday. He called it “significantly improved” and said it was functioning “effectively for the vast majority of users.” Carney spoke of a “vast improvement” and said the White House had reached its goal that “the vast majority of users are able to access the site and have it function effectively.”....

Conveniently, figures leaked Monday indicated that 100,000 people signed up for insurance on HealthCare.gov in November, quadruple October’s dismal result. Democratic lawmakers came out of hiding and spoke of the improvements with a spirit that had eluded them in the weeks since the Web site crashed on launch.

But the real gauge of HealthCare.gov’s improvement was Republicans’ response — or lack thereof. When the House returned from Thanksgiving recess on Monday afternoon, the GOP speakers on the floor essentially ignored the Web site, instead returning to their earlier denunciations of Obamacare overall and President Obama in general.

Carney was right not to claim victory. The rollout of Obamacare this fall, particularly the president’s broken promise that people who like their health plans would be able to keep them, have damaged Obama’s credibility, probably permanently. Many people — including young voters who disproportionately supported Obama — have lost their catastrophic-coverage plans and now must pay significantly more to get new, bigger plans. And it’s still not certain that the health-care exchanges at the heart of the law will be viable.

But fixing the Web site after its embarrassing launch means that opponents of the Affordable Care Act have lost what may have been their last chance to do away with the law. And supporters can rule out the worst-case scenario: Obamacare isn’t going away. Even some conservatives have begun to tiptoe away from an opposition to the law that looked much like sabotage.

You could have knocked me over with a feather after I read this paragraph:

Last week, Rep. Jack Kingston (R-Ga.), a Senate candidate, told a local radio station, Z Politics, that “a lot of conservatives say, ‘Nah, let’s just step back and let this thing fall to pieces on its own.’ But I don’t think that’s always the responsible thing to do. .?.?. I think we need to be looking for things that improve health-care overall for all of us. And if there is something in Obamacare, we need to know about it.”

Political conventional wisdom has it that in a purple state, such as Virginia, support for gun-safety legislation is best played down. As manager of Mark Herring’s campaign for attorney general, I got a lot of advice. One of the things I heard most frequently was that we should soft-pedal his strong record and advocacy for sensible gun legislation. It would hurt us outside of Northern Virginia and wasn’t a voting issue within the Beltway, I was told.

Like much conventional wisdom, this was wrong — and we not only ignored this advice but did the opposite. There were stark differences between Herring and his Republican opponent, Sen. Mark D. Obenshain (R-Harrisonburg), on gun safety. Obenshain opposed comprehensive background checks and opposed closing the gun-show loophole. He opposed former governor Douglas Wilder’s landmark “one-gun-a-month” legislation. Obenshain also made a habit of voting for such irresponsible proposals as allowing guns in bars and restaurants where alcohol is served.

In short, Obenshain has opposed every constructive proposal to help reduce gun violence.

We knew this would open an opportunity for us to draw an effective contrast; public polling showed widespread support for sensible gun-safety laws, as did our own polling. Hence, more than a year out from Election Day, dealing with gun violence was a fundamental messaging point for Herring. And when the primary was over, and Herring and Obenshain met in their first debate, he drew a sharp contrast with his opponent on guns. We would prosecute that case throughout the fall campaign.

Though Obenshein has called for a recount, that will likely increase the margin of victory for Herring, as the urban voters tend to be undercounted more than rural ones, and Herring dominated the urban areas. It will be interesting to see how Herring approaches gun violence as VA AG.